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Stress echocardiography with smartphone: real-time remote reading for regional wall motion

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Abstract

The diffusion of smart-phones offers access to the best remote expertise in stress echo (SE). To evaluate the reliability of SE based on smart-phone filming and reading. A set of 20 SE video-clips were read in random sequence with a multiple choice six-answer test by ten readers from five different countries (Italy, Brazil, Serbia, Bulgaria, Russia) of the “SE2020” study network. The gold standard to assess accuracy was a core-lab expert reader in agreement with angiographic verification (0 = wrong, 1 = right). The same set of 20 SE studies were read, in random order and >2 months apart, on desktop Workstation and via smartphones by ten remote readers. Image quality was graded from 1 = poor but readable, to 3 = excellent. Kappa (k) statistics was used to assess intra- and inter-observer agreement. The image quality was comparable in desktop workstation vs. smartphone (2.0 ± 0.5 vs. 2.4 ± 0.7, p = NS). The average reading time per case was similar for desktop versus smartphone (90 ± 39 vs. 82 ± 54 s, p = NS). The overall diagnostic accuracy of the ten readers was similar for desktop workstation vs. smartphone (84 vs. 91%, p = NS). Intra-observer agreement (desktop vs. smartphone) was good (k = 0.81 ± 0.14). Inter-observer agreement was good and similar via desktop or smartphone (k = 0.69 vs. k = 0.72, p = NS). The diagnostic accuracy and consistency of SE reading among certified readers was high and similar via desktop workstation or via smartphone.

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Abbreviations

SE:

Stress echocardiography

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Acknowledgements

The study was supported by institutional funding of the Institute of Clinical Physiology of the Italian National Research Council.

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Authors and Affiliations

  1. Cardiology Division, Nottola Hospital, Siena, Italy

    Maria Chiara Scali

  2. Hospital de Clinicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Clarissa Carmona de Azevedo Bellagamba & Marco R. Torres

  3. Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy

    Quirino Ciampi

  4. Acibadem City Clinic Cardiovascular Center, University Hospital, Sofia, Bulgaria

    Iana Simova

  5. Hospital Sao Vicente de Paulo and Hospital de Cidade, Passo Fundo, Brazil

    José Luis de Castro e Silva Pretto

  6. Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia

    Ana Djordjevic-Dikic

  7. Casa di Cura Figlie di San Camillo, Cremona, Italy

    Claudio Dodi

  8. Cardiology Department, San Luca Hospital, Lucca, Italy

    Lauro Cortigiani

  9. Cardiology Department, Medika Cardiocenter, Saint Petersburg, Russian Federation

    Angela Zagatina

  10. Cardiology Department, Sandro Pertini Hospital, Rome, Italy

    Paolo Trambaiolo

  11. Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy

    Rodolfo Citro

  12. Heart Cardiology Hospital, Policlinico of Bari, Bari, Italy

    Paolo Colonna

  13. Biomedicine Department, CNR, Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, 56 124, Pisa, Italy

    Marco Paterni & Eugenio Picano

  14. Cardiothoracic Department, Cisanello, Pisa, Italy

    Maria Chiara Scali

Authors
  1. Maria Chiara Scali
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  2. Clarissa Carmona de Azevedo Bellagamba
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  3. Quirino Ciampi
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  4. Iana Simova
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  5. José Luis de Castro e Silva Pretto
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  6. Ana Djordjevic-Dikic
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  7. Claudio Dodi
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  8. Lauro Cortigiani
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  9. Angela Zagatina
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  10. Paolo Trambaiolo
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  11. Marco R. Torres
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  12. Rodolfo Citro
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  13. Paolo Colonna
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  14. Marco Paterni
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  15. Eugenio Picano
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on behalf of the Stress Echo 2020 study group of the Italian Society of Cardiovascular Echography

Corresponding author

Correspondence to Eugenio Picano.

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The authors declare that they have no conflicts of interest.

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Scali, M.C., de Azevedo Bellagamba, C.C., Ciampi, Q. et al. Stress echocardiography with smartphone: real-time remote reading for regional wall motion. Int J Cardiovasc Imaging 33, 1731–1736 (2017). https://doi.org/10.1007/s10554-017-1167-2

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  • DOI: https://doi.org/10.1007/s10554-017-1167-2

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